Postdelivery Pain: Less Medication Required

Study of Womens' Pain Following Discharge Leads to New Recommendations

A study conducted by researchers from Stanford University seeks to enhance our understanding of the experience of pain among women, who have undergone vaginal delivery, in the period after they have been discharged from the hospital. Lead author Ryu Komatsu, MD, a physician anesthesiologist at Stanford, observed, “Most available information about women’s pain after delivery is limited to the 48 to 72 hours women are in the hospital after giving birth. There are little data about what happens during the postpartum period, between the time a woman is discharged from the hospital and 6 weeks later when she visits her OB/GYN. We wanted to see how long it takes for the pain to resolve as well as when women regain their daily functionality.” The research concludes that opioid medication is often not indicated for pain management in this time period and further, that opioid use can probably be reduced among women who undergo caesarian delivery. The findings were published in the journal Anesthesiology.

The study followed 213 women who were healthy, first-time mothers. Subjects were polled daily following delivery about pain medication use, their pain levels, and degree of functional recovery. The team found that 31% of women who had a vaginal delivery used opioids immediately following, and less than 10% continued their use after hospital discharge. Median time for discontinuing all pain medications, including NSAIDs, was 11 days. 91% of women who underwent caesarian delivery needed opioids for pain, with a median time to cessation of 9 days. Normal levels of functionality returned for 95% of vaginal delivery and caesarian delivery subjects in 47 days and 57 days respectively. The authors interpret their findings to suggest that postpartum pain management can, in most cases, be accomplished with limited or no use of opioids, but add that evaluation of individual patient needs is still required.